VENOM ANAPHYLAXIS
Hülya Anıl
Eskişehir Osmangazi University, Faculty of Medicine, Department of Pediatric Immunology and Allergic Diseases, Eskişehir, Türkiye
Anıl H. Venom Anaphylaxis. In: Harmancı K, editor. Childhood Anaphylaxis: New Developments in Diagnosis and Treatment. 1st ed. Ankara: Türkiye Klinikleri; 2025. p.105-113.
ABSTRACT
Although venom anaphylaxis is rare in the pediatric population, it is clinically significant due to its risk of mortality. Worldwide, and in this group, anaphylaxis caused by Hymenoptera species is the most common. Immunotherapy is the only significant option for the prevention of venom anaphylaxis. To identify suitable candidates for venom immunotherapy, which has immunomodulatory effects, skin prick tests, intradermal tests, basophil activation tests, and component-resolved diagnostics are used. Based on the results of these evaluations, the risk of mortality from venom anaphylaxis can be reduced by selecting the appropriate patient and the appropriate formulation..
Keywords: Hymenoptera; Venom immunotherapy; Adrenaline
Kaynak Göster
Referanslar
- Grabenhenrich LB, Dölle S, Moneret-Vautrin A, Köhli A, Lange L, Spindler T, et al. Anaphylaxis in children and adolescents: the European Anaphylaxis Registry. J Allergy Clin Immunol. 2016;137:1128.e1-1137.e1. [Crossref] [PubMed]
- Worm M, Moneret-Vautrin A, Scherer K, Lang R, Fernandez-Rivas M, Cardona V, et al. First European data from the network of severe allergic reactions (NORA). Allergy. 2014;69(10):1397-1404. [Crossref] [PubMed]
- Bilo MB, Ollert M, Blank S. The role of component-resolved diagnosis in Hymenoptera venom allergy. Curr Opin Allergy Clin ımmunol. 2019;19:614-622. [Crossref] [PubMed]
- Jeong, KY, Yi MH, Son M, Lyu D, Lee JH, Yong TS. IgE Reactivity of Recombinant Pac c 3 from the Asian Needle Ant (Pachycondyla chinensis). Int. Arch. Allergy Immunol. 2016;169(2):93-100. [Crossref] [PubMed]
- Feás X, Vidal C, Remesar S. What We Know about Sting-Re lated Deaths? Human Fatalities Caused by Hornet, Wasp and Bee Stings in Europe (1994-2016). Biology. 2022;11(2):282. [Crossref] [PubMed] [PMC]
- Blank S, Pehlivanli S, Methe H, Schmidt-Weber CB, Biedermann T, Horny H.P, et al. Fatal Anaphylaxis Following a Hornet Sting in a Yellow Jacket Venom-Sensitized Patient with Undetected Monoclonal Mast Cell Activation Syndrome and without Previous History of a Systemic Sting Reaction. J Allergy Clin Immunol Pract. 2020;8(1):401-403.e2. [Crossref] [PubMed]
- Bilo BM, Bonifazi F. Epidemiology of insect-venom anaphylaxis. Curr Opin Allergy Clin Immunol. 2008;8(4):330-7. [Crossref] [PubMed]
- Jennings A, Duggan E, Perry IJ, Hourihane JO. Epidemiology of allergic reactions to hymenoptera stings in Irish school children. Pediatr Allergy Immunol. 2010;21(8):1166-70. [Crossref] [PubMed]
- Bilo BM, Rueff F, Mosbech H, Bonifazi F, Oude-Elberink JN. EAACI Interest Group on Insect Venom Hypersen Anıl Venom Anaphylaxis sitivity. Diagnosis of Hymenoptera venom allergy. Allergy. 2005;60(11):1339-49. [Crossref] [PubMed]
- Golden DB. Insect sting allergy and venom immunotherapy: a model and a mystery. J Allergy Clin Immunol 2005;115:439-47. [Crossref] [PubMed]
- Soyak Aytekin E, Şirin S, Kıratlı Nalbant E, Ata N, Sertçelik A, Ülgü MM, et al. Changes in anaphylaxis trends and characteristics in emergency department admissions in Turkiye: From 2015 to 2021 based on the Ministry of Health database. World Allergy Organ J. 2024;18(1):101019. [Crossref] [PubMed] [PMC]
- Golden DB. Anaphylaxis to Insect Stings. Immunol. Allergy Clin. N. Am. 2015;35(2):287-302. [Crossref] [PubMed]
- Nittner-Marszalska M, Kopec A, Biegus M, Kosinska M, Obojski A, Pawłowicz R. Non-ST Segment Elevation Myocardial Infarction after Multiple Bee Stings. A Case of "Delayed" Kounis II Syndrome? Int. J.Cardiol. 2013, 166, e62- e65. [Crossref] [PubMed]
- Bilo MB, Pravettoni V, Bignardi D, Bonadonna P, Mauro M, Novembre E, et al. Hymenoptera Venom Allergy:Management of children and adults inclinical practice. J Investig Allergol ClinImmunol. 2019;29:180-205. [Crossref] [PubMed]
- Mullins RJ, Wainstein BK, Barnes EH, Liew WK, Campbell DE. Increases in anaphylaxis fatalities in Australia from 1997 to 2013. Clin Exp Allergy. 2016;46:1099-1110. [Crossref] [PubMed]
- Norelli F, Gueli V, Bonadonna P. Hymenoptera venom allergy in children and adolescent. Curr Opin Allergy Clin Immunol. 2024;24(5):322-329. [Crossref] [PubMed]
- Ring J, Messmer K. Incidence and severity of anaphylactoid reactions to colloid volüme substitutes. Lancet. 1977;1:466-9. [Crossref] [PubMed]
- Mueller HL. Further experiences with severe allergic reactions to insect stings. N Engl j med. 1959;261:374-7. [Crossref] [PubMed]
- Muraro A, Fernandez-Rivas M, Beyer K, Cardona V, Clark A, Eller E, et al. The urgent need for a harmonized severity scoring system for acute allergic reactions. Allergy. 2018;73:1792-1800. [Crossref] [PubMed]
- Fehr D, Micaletto S, Moehr T, Schmid-Grendelmeier P. Risk Factors for Severe Systemic Sting Reactions in Wasp (Vespula Spp.) and Honeybee (Apis Mellifera) Venom Allergic Patients. Clin Transl. Allergy. 2019;9:54. [Crossref] [PubMed] [PMC]
- Stoevesandt J, Sturm GJ, Bonadonna P, Oude Elberink JNG, Trautmann A. Risk factors and indicators of severe systemic insect sting reactions. Allergy. 2020;75:535-45. [Crossref] [PubMed]
- Yavuz ST, Sahiner UM, Buyuktiryaki B, Soyer OU, Sack esen C, Sekerel BE, et al. Clinical features of children with venom allergy and risk factors for severe systemic reactions. Int Arch Allergy Immunol. 2013;160:313-21. [Crossref] [PubMed]
- Bonadonna P, Lombardo C, Zanotti R. Mastocytosis and allergic diseases. J Investig Allergol Clin Immunol 2014;24:288-97.
- Vázquez-Revuelta P, González-de-Olano D. Prevalence of clonal mast cell disorders in patients presenting with hymenoptera venom anaphylaxis might be higher than expected. J Investig Allergol Clin Immunol. 2018;28:193-4. [Crossref] [PubMed]
- Alvarez-Twose I, González de Olano D, Sánchez-Muñoz L, Matito A, EstebanLópez MI, Vega A, et al. Clinical, biological, and molecular characteristics of clonal mast cell disorders presenting with systemic mast cell activation symptoms. J Allergy Clin Immunol. 2010;125:1269-1278. [Crossref] [PubMed]
- Müller UR, Horat W, Wüthrich B, Conroy M, Reisman RE. Anaphylaxis after Hymenoptera stings in three patients with urticaria pigmentosa. J Allergy Clin Immunol. 1983;72:685-9. [Crossref] [PubMed]
- Kors JW, van Doormaal JJ, de Monchy JG. Anaphylactoid shock following Hymenoptera sting as a presenting symptom of systemic mastocytosis. J Intern Med. 1993;233:255-8. [Crossref] [PubMed]
- Ludolph-Hauser D, Ruëff F, Fries C, Schöpf P, Przybilla B. Constitutively raised serum concentrations of mast-cell tryptase and severe anaphylactic reactions to Hymenoptera stings. Lancet 2001;357:361-2. [Crossref] [PubMed]
- Pfaar O, Bachert C, Bufe A, Buhl R, Ebner C, Eng P, et al. Guideline on Allergen-Specific Immunotherapy in IgE-Mediated Allergic Diseases: S2k Guideline of the German Society for Allergology and Clinical Immunology (DGAKI), the Society for Pediatric Allergy and Environmental Medicine (GPA), the Medical Association of German Allergologists (AeDA), the Austrian Society for Allergy and Immunology (ÖGAI), the Swiss Society for Allergy and Immunology (SGAI), the German Society of Dermatology (DDG), the German Society of Oto-Rhino-Laryngology, Head and Neck. Allergo J. Int. 2014, 23, 28-67. [Crossref] [PubMed] [PMC]
- Bilo BM, Bonifazi F. Hymenoptera Venom Immunotherapy. Immunotherapy 2011;3:229-246. [Crossref] [PubMed]
- Golden DB, Kagey-Sobotka A, Norman PS, Hamilton RG, Linchtenstein LM. Outcomes of allergy to insect stings in children, with and without venom immunotherapy. N Engl J Med 2004;351:668-74. [Crossref] [PubMed]
- Cichocka-Jarosz E, Stobiecki M, Brzyski P, Rogatko I, Nittner-Marszalska M, Sztefko K, et al. Simplification of intradermal skin testing in Hymenoptera venom allergic children. Ann Allergy Asthma Immunol. 2017;118:326-332. [Crossref] [PubMed]
- Vos B, Köhler J, Müller S, Stretz E, Ruëff F, Jakob T. Spiking Venom with RVes v 5 Improves Sensitivity of IgE Detection in Patients with Allergy to Vespula Venom. J Allergy Clin. Immunol. 2013;131:1225-1227. [Crossref] [PubMed]
- Möbs C, Ipsen H, Mayer L, Slotosch C, Petersen A, Würtzen PA, et al. Birch Pollen Immunotherapy Results in Long-Term Loss of Bet v 1-Specific TH2 Responses, Transient TR1 Activation, and Synthesis of IgE-Blocking Antibodies. J Allergy Clin Immunol. 2012;130:1108-1116. [Crossref] [PubMed]
- van de Veen W, Stanic B, Wirz OF, Jansen K, Globinska A, Akdis M. Role of Regulatory B Cells in Immune Tolerance to Allergens and Beyond. J. Allergy Clin. Immunol. 2016;138: 654-665. [Crossref] [PubMed]
- Blank S, Seismann H, Michel Y, McIntyre M, Cifuentes L, Braren I, et al. Api m 10, a Genuine A. mellifera Venom Allergen, Is Clinically Relevant but Underrepresented in Therapeutic Extracts. Allergy. 2011;66:1322-1329. [Crossref] [PubMed]
- Alfaya Arias T, Soriano Gómis V, Soto Mera T, Vega Castro A, Vega Gutiérre J.M, Alonso Llamazares A, et al. Key Issues in Hymenoptera Venom Allergy: An Update. J. Investig. Allergol. Clin. Immunol. 2017:27:19-31. [Crossref] [PubMed]
- Golden DB, Kagey-Sobotka A, Norman PS, Hamilton RG, Lichtenstein LM. Insect sting allergy with negative venom skin test responses. J Allergy Clin Immunol. 2001;107:897901. [Crossref] [PubMed]
- Korosec P, Erzen R, Silar M, Bajrovic N, Kopac P, Kosnik M. Basophil responsiveness in patients with insect sting allergies and negative venomspecific immunoglobulin E and skin prick test results. Clin Exp Allergy. 2009;39:1730-7. [Crossref] [PubMed]
- Sturm GJ, Kranzelbinder B, Schuster C, Sturm EM, Bokanovic D, Vollmann J, et al. Sensitization to Hymenoptera venoms is common, but systemic sting reactions are rare. J Allergy Clin Immunol. 2014;133:1635-16343.e1. [Crossref] [PubMed]
- Bonadonna P, Korosec P, Nalin F, Golden D. Venom anaphylaxis: Decision Points for a More Aggressive Workup. J Allergy Clin İmmunol Pract. 2023;11(7):2024-2031. [Crossref] [PubMed]
- Spillner E, Blank S, Jakob T. Hymenoptera allergens: from venom to "venome". Front Immunol. 2014;5:77. [Crossref] [PubMed] [PMC]
- Frick M, Muller S, Bantleon F, Huss-Marp J, Lidholm J, Spillner E, et al. rApim 3 and rApi m 10 improve detection of honey bee sensitization in Hymenoptera venom-allergic patients with double sensitization to honey bee and yellow jacket venom. Allergy 2015;70:1665-8. [Crossref] [PubMed]
- Frick M, Fischer J, Helbling A, Rueff F, Wieczorek D, Ollert M, et al. Predominant Api m 10 sensitization as risk factor for treatment failure in honey bee venom immunotherapy. J Allergy Clin Immunol. 2016;138:1663-1671. [Crossref] [PubMed]
- Hoffmann HJ, Santos AF, Mayorga C, Nopp A, Eberlein B, Ferrer M, et al. The clinical utility of basophil activation testing in diagnosis and monitoring of allergic disease. Allergy. 2015;70:1393-405. [Crossref] [PubMed]
- Santos AF, Alpan O, Hoffmann HJ. Basophil activation test: mechanisms and considerations for use in clinical trials and clinical practice. Allergy. 2021;76:2420-32. [Crossref] [PubMed]
- Eberlein B. Basophil activation as marker of clinically relevant allergy and therapy outcome. Front Immunol. 2020;11:1815. [Crossref] [PubMed] [PMC]
- Kopac P, Custovic A, Zidarn M, Silar M, Selb J, Bajrovic N, et al. Biomarkers of the severity of honeybee sting reactions and the severity and threshold of systemic adverse events during immunotherapy. J Allergy Clin Immunol Pract. 2021;9:3157-3163. [Crossref] [PubMed]
- Valent P, Akin C, Arock M, Brockow K, Butterfield JH, Carter MC, et al. Definitions, criteria and global classification of mast cell disorders with special reference to mast cell activation syndromes: a consensus proposal. Int Arch Allergy Immunol. 2012;157:215-25. [Crossref] [PubMed] [PMC]
- van de Veen W, Stanic B, Yaman G, Wawrzyniak M, Söllner S, Akdis DG, et al. IgG4 Production Is Confined to Human IL-10-Producing Regulatory B Cells That Suppress Antigen-Specific Immune Responses. J. Allergy Clin. Immunol. 2013;131:1204-1212. [Crossref] [PubMed]
- Karagol HIE, Bakirtas A, Yilmaz O, Topal E, Arga M, Demirsoy MS, et al. Comparison of moderate to severe systemic reactions with honeybee and wasp in children. Int Forum Allergy Rhinol. 2014;4:548-554. [Crossref] [PubMed]
- Sturm GJ, Varga EM, Roberts G, Mosbech H, Bilo MB, Akdis CA, et al. EAACI guidelines on allergen immunotherapy: Hymenoptera venom allergy. Allergy. 2018;73:744-64. [Crossref] [PubMed]
- Stritzke AI, Eng PA. Age-dependent sting recurrence and outcome inimmuno therapy-treated children with anaphylaxis to Hymenoptera venom. Clin Exp Allergy. 2013;43(8):950955. [Crossref] [PubMed]
- Zahirović A, Luzar J, Molek P, Kruljec N, Lunder M.Bee Venom Immunotherapy: Current Status and Future Directions. Clin Rev Allergy Immunol. 2020;58(3):326-341. [Crossref] [PubMed]
- Droitcourt C, Ponvert C, Dupuy A, Scheinmann P, Abou-Taam R, de Blic J, et al. Efficacy of a short pretreatment with omalizumab in children with anaphylaxis to hymenoptera venom immunotherapy: a report of three cases. Allergol Int. 2019;68:268-269. [Crossref] [PubMed]
- Floyd ML, Adams KE, Golden DBK. Updates and re Anıl Venom Anaphylaxis cent advances on venom immunotherapy. Curr Treat Options Allergy. 2023;29:1-19.
- Fiedler C, Miehe U, Treudler R, Kiess W,Prenzel F. Long Term Follow-Up of Children after Venom Immunotherap: Low Adherence to Anaphylaxis Guidelines. Int Arch Allergy Immunol. 2017;172(3):167-172. [Crossref] [PubMed]